The psychodiagnostic assessment training is an integral part of the NAAPTC pre-doctoral internship. It consists of a weekly one and a half hour Assessment Seminar/Group Supervision and an hour individual supervision on testing cases. This program involves both theoretical learning and practical application of assessment skills. Each intern is required to complete six in depth testing batteries during the training year, and the core didactic curriculum is supplemented with didactic training covering issues that arise as students deal with their assigned assessment cases and/or issues related to students’ particular areas of interest.
Core Curriculum:
Introduction to the Program or what are we going to do this year? including discussion of the students’ background knowledge and interests in relation to assessment training at the NAAPTC.
Clinical Aspects of Testing or what is the point? including effective communication with the referral sources; ability to provide a coherent and comprehensible case formulation based on the testing data; using consultation, clinical charts and outside reports; effectively addressing referral questions; formulating recommendations and suggestions for a treatment plan, and providing feedback to the clients and/or referral sources.
Introduction to Neuropsychology or what about the body? including basic information needed to understand biological variables essential for testing (Central Nervous System anatomy, sensorium, endocrinology, drugs, neurological exam).
Mental Status Exam and basic Neurological Screening or what are we looking for? including basic signs and symptoms relevant to the assessment process.
Basic Psychometric Issues in testing or what can we trust? including quantitative and qualitative interpretation, validity and reliability.
Ethical and Legal Issues in Assessment or what are the does and don’ts? including informed consent, security of data, release of information, limits of competency issues, etc.
Commonly Used Measures or what can we use? including such tests (covered in the licensing exam!) as WAIS-IV & WISC-IV; Rorschach (Exner system); MMPI-2; MCMI; TAT & CAT; WRAT-4; Projective Drawings; Rotter’s Incomplete Sentence Blank; and other measures of interest to the interns.
Assessment of Specific Populations or how do we apply what we know to real people? including assessment of children (rapport issues, working with parents and teachers, assessment of Mental Retardation, ADHD, learning disabilities, etc.); geriatric assessment (Dementias, Delirium, psychiatric illnesses, etc.), assessment of substance abusers; assessment of cultural minorities; and other populations of interest to students.
Practical Testing Experience:
The practical part of the training consists of thorough assessment of three or four patients: clarifying the referral questions; collecting historical information; administering and scoring assessment measures; interpreting the data; writing reports and providing feedback to the clients and referral sources. At a minimum, each in-depth assessment battery includes a thorough Mental Status Exam, a basic neuropsychological screening, WAIS-IV or WISC-IV, and the Rorschach or TAT and MMPI-2 or BAI/BDI. Typically, these assessment techniques are supplemented by other measures pertaining to specific referral questions. Given the diversity of the populations served by RAMS, the trainees have some latitude in selecting their testing cases, including the opportunity to test adults and children with a variety of diagnoses and cultural backgrounds, and to provide consultations on assessment and treatment plan development within the outpatient and residential treatment settings.
Assessment Report:
All testing reports will have unique characteristics as symptom complexity, life history, synergistic medical conditions, etc. will create the need to elaborate or conversely, diminish in scope, aspects of the report. The following basic structure is suggested for all reports:
Header: Name, Date of Birth, Age, Ethnicity/Language, Parents (if applicable), Placement, Education, Occupation, Handedness, Dates of Examination, Date of Report, Examiners
I. Identification and Presenting Problem: Brief description of the client and the reason for assessment, including referral source and precise referral questions.
II. Relevant History: Identify and describe sources of information for all aspects of history.
1) History of present illness.
2) Social/family history.
3) Educational history.
4) Legal history.
5) Habit/Substance use history.
6) Military history.
7) Work history.
8) Cultural and spiritual history.
9) Hobbies, leisure time pursuits.
10) Medical history including medications currently prescribed.
11) Psychiatric history including medications currently prescribed.
12) Review of records not reviewed in other sections.
III. Behavioral Observations: Client’s distinguishing features, including use of prosthetic devises/aids. Client’s primary language and language of assessment. Self-reported level of physical comfort during the examination: any medications or chemical substances taken; corrective devices worn; complaints, if any. Mental Status Exam. Behavior during testing: problem-solving approach, level of cooperation and effort, anxiety. Validity of current testing (based on observations during testing, validity scales, and malingering tests, if any); include description of efforts made to accommodate testing conditions to specific needs of the client and caveats about possible inaccuracies due to language, culture, education, sensory deficits, and tests or norm deficiencies at the end of this section.
IV. Tests and Procedures Administered: List all the tests by their full name.
V. Test Results: Combine the results of particular tests into coherent assessment of the domains of functioning. Include interpretation of data and ranges and/or percentiles.
1) Overall Intellectual/Cognitive Functioning.
2) Attention/Concentration.
3) Language.
4) Visual-Spatial and Motor Functioning.
5) Memory and Learning.
6) Abstract Reasoning.
7) Emotional/Interpersonal/Adaptive Functioning.
VI. Discussion: Summarize the history, behavioral observations, and test results into a coherent diagnostic picture. Your goal is to provide evidence for your diagnosis and to substantiate your recommendations. Each diagnosis should be justified by specific, direct reference to exact DSM IV criteria. Address referral questions here.
VII. DSM-IV Diagnosis: Provide codes and diagnoses on all five axes.
VIII. Recommendations: Concrete recommendations for procedures and treatment.
More information about the Psychodyagnostic Assessment Training, including the basic training materials and the contact information for the assessment supervisor Dr. Anastasya Glezerman can be found at Dr. Glezerman’s website: http://www.scarletline.com/aglezerman/